Presentation
Status post left subclavian.
Patient Data
There is a new left subclavian central venous catheter the tip never crosses the midline. The tip overlies the aortic arch. Recommend correlation with arterial blood gas analysis to make sure this is not an arterial placement in the subclavian artery.
There is no left pneumothorax.
Impression:
1. Recommend arterial blood gas analysis to make sure this is not a left subclavian artery placement. If not can consider doing an ultrasound of the subclavian region.
This could be artifactual given patient's severe deformities of the chest and this is a venous placement.
The other differential diagnoses is the patient has a left-sided SVC. On the prior CT of the thoracic spine without contrast, there was no persistent left SVC.
Case Discussion
The central line was removed without complications and placed elsewhere.
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